Provider Demographics
NPI:1184370322
Name:AESTHETICS MONTECITO
Entity type:Organization
Organization Name:AESTHETICS MONTECITO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:PA, C
Authorized Official - Phone:805-565-8480
Mailing Address - Street 1:1805 E CABRILLO BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2884
Mailing Address - Country:US
Mailing Address - Phone:805-565-8480
Mailing Address - Fax:805-565-8481
Practice Address - Street 1:1805 E CABRILLO BLVD STE C
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93108-2884
Practice Address - Country:US
Practice Address - Phone:805-565-8480
Practice Address - Fax:805-565-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty